摘要
目的研究完全腹膜外腹腔镜腹股沟疝修补术对睾丸血流灌注及体积的影响。方法 2009年7月-2011年5月,对62例行完全腹膜外腹腔镜单侧腹股沟疝修补术男性患者进行自身前后对照研究,比较术前、术后患侧睾丸的睾丸动脉(TA)、睾丸包膜动脉(CA)、睾丸内动脉(ITA)血流参数[收缩期峰值血流速度(PSV)、舒张未期血流速度(EDV)及血管阻力指数(RI)]、睾丸体积(TV)及血清睾酮的变化情况。结果患者获随访7～24个月,平均15.6个月,无复发患者。术前及术后3、6个月时患侧TV分别为(9.91±3.72)、(10.23±4.18)和(10.16±3.94)cm3,同期血浆睾酮水平分别为(544.25±123.72)、(532.89±145.66)和(565.65±138.13)μg/L,手术前后比较患侧TV(F=1.350,P=0.263)、血浆睾酮水平(F=1.673,P=0.192)无统计学意义,血浆睾酮水平均在正常范围内。术后3、6个月患侧TA、CA和ITA的EDV明显高于术前,RI较术前明显降低,差异均有统计学意义(P<0.05);PSV与术前比较差异无统计学意义(P>0.05)。术后3个月患侧睾丸各动脉PSV、EDV、RI与术后6个月比较差异无统计学意义(P>0.05)。结论完全腹膜外腹腔镜腹股沟疝修补术后患侧睾丸血流灌注情况可能会有所改善,不影响TV及血清睾酮水平。
Objective To investigate the impact of totally laparoscopic extraperitoneal inguinal hernia repair on testicular perfusion and volume. Methods From July 2009 to May 2011, a total of 62 male patients with unilateral inguinal hernia undergoing totally laparoscopic extraperitoneal herniorrhaphy were enrolled in a prospective internally controlled cohort study. Pre- and Post-operative blood flow parameters of testicular artery （TA）, capsular artery （CA）, intratesticular artery （ITA） on the affected side, including peak systolic velocity （PSV）, end diastolic velocity （EDV）, resistance index （RI）, testicular volume （TV）, and plasma testosterone level were studied and compared. Results Follow-up continued for 7 to 24 months, averaging 15.6 months. There was no recurrence during this period. The mean testis volume preoperatively, 3 and 6 months postoperatively were （9.91 ~ 3.72） cm3, 10.23 ~ 4.18 cm3 and （10.16 ~ 3.94） cm3. Meanwhile, the mean plasma testosterone level of those time points were respectively （544.25 ~ 123.72） ktg/L, （532.89 ~ 145.66） ktg/L and （565.65 ＋ 138.13） }.tg/L, and these values were all within normal limits. There were no statistically significant differences in testicular volume and plasma testosterone level between the preoperative and postoperative period （P 〉 0.05）. Compared with preoperative testicular blood flow parameters, EDV was significantly higher and RI was significantly lower 3 and 6 months after operation in TA, CA and ITA （P 〈 0.05）, while PSV was not significantly different （P 〉 0.05）. PSV, EDV and RI 3 months postoperatively in TA and its branches were not significantly different from those 6 months postoperatively （P 〉 0.05）. Conclusion Testicular perfusion on the affected side can be improved after totally laparoscopic extraperitoneal inguinal hernia repair, while testicular volume and plasma testosterone level are not influenced.
出处
《华西医学》
CAS
2012年第7期1011-1014,共4页
West China Medical Journal
关键词
腹腔镜
完全腹膜外疝修补术
睾丸
Laparoscope
Totally extraperitoneal hemia repair
Testis
